MPs call for free personal care for elderly people
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《英国医生杂志》
The distinction between health and social care should be abolished, allowing elderly people to be looked after by a single generic agency, a parliamentary committee recommended this week. The lack of integration between the sectors is a "serious stumbling block" to providing a good quality service to elderly patients, the committee抯 report argues.
Three weeks after Stephen Ladyman, the minister for community care, insisted to the House of Commons Health Committee that the government would "absolutely not" consider offering free personal care to elderly people on the NHS, members of the committee have nevertheless gone on to criticise the unfairness and inefficiency of a system that is based on an "artificial distinction between a universal and free health care service operating alongside a means-tested and charged-for system of social care."
The current system permits the NHS to neglect patients with mental health problems, which affect up to 75% of patients in care homes, and to waste "significant" amounts of money on lengthy administrative battles over who is responsible for paying for treatment, they claim.
"The ?.5bn which estimates it would cost to provide free personal care today is dwarfed by the current ?0bn spend on health care," added the report. "The costs of providing free personal care would be affordable," it concluded.
The committee also criticised the Department of Health抯 lack of progress in developing a new set of national eligibility criteria for continuing care, arguing that the status quo has meant that many patients have been wrongfully denied funding. Too often local assessments are driven by "budgetary concerns rather than patient need," says the report. "The NHS has an urgent need for a single, universal set of national eligibility criteria for continuing care to end the inequities and inconsistencies that have developed as a result of the current system."
The MPs warned that in the future these inequalities could result in a pattern of "cherry picking," whereby care homes favour patients from areas with more generous eligibility criteria because they are guaranteed greater funding. Dr Ladyman has committed the government to developing a national set of standard criteria over the course of the next year, but the committee said that the government "ought to have acted sooner."
"We are concerned that it has taken so long for the department to recognise and address the problem" says the report. "Elderly people ?still find themselves subject to a bewildering funding system which is little understood even by those who administer it."
It is estimated that as many as one in three women and one in five men will eventually need long term residential care. With the decline of the long stay hospital and the expected rise in the number of elderly people with complicated health needs because of Alzheimer抯 disease and other dementias, the committee is concerned that the government address these issues as a matter of urgency.
A spokesperson for the charity Help the Aged welcomed the report: "For too long older people have been left confused and uncertain about their entitlement ?the current continuing care system is a confusing and distressing postcode lottery. Help the Aged hopes that whatever government is elected on 5 May will implement these recommendations as a matter of urgency and put an end to the confusion."(Madeleine Brettingham)
Three weeks after Stephen Ladyman, the minister for community care, insisted to the House of Commons Health Committee that the government would "absolutely not" consider offering free personal care to elderly people on the NHS, members of the committee have nevertheless gone on to criticise the unfairness and inefficiency of a system that is based on an "artificial distinction between a universal and free health care service operating alongside a means-tested and charged-for system of social care."
The current system permits the NHS to neglect patients with mental health problems, which affect up to 75% of patients in care homes, and to waste "significant" amounts of money on lengthy administrative battles over who is responsible for paying for treatment, they claim.
"The ?.5bn which estimates it would cost to provide free personal care today is dwarfed by the current ?0bn spend on health care," added the report. "The costs of providing free personal care would be affordable," it concluded.
The committee also criticised the Department of Health抯 lack of progress in developing a new set of national eligibility criteria for continuing care, arguing that the status quo has meant that many patients have been wrongfully denied funding. Too often local assessments are driven by "budgetary concerns rather than patient need," says the report. "The NHS has an urgent need for a single, universal set of national eligibility criteria for continuing care to end the inequities and inconsistencies that have developed as a result of the current system."
The MPs warned that in the future these inequalities could result in a pattern of "cherry picking," whereby care homes favour patients from areas with more generous eligibility criteria because they are guaranteed greater funding. Dr Ladyman has committed the government to developing a national set of standard criteria over the course of the next year, but the committee said that the government "ought to have acted sooner."
"We are concerned that it has taken so long for the department to recognise and address the problem" says the report. "Elderly people ?still find themselves subject to a bewildering funding system which is little understood even by those who administer it."
It is estimated that as many as one in three women and one in five men will eventually need long term residential care. With the decline of the long stay hospital and the expected rise in the number of elderly people with complicated health needs because of Alzheimer抯 disease and other dementias, the committee is concerned that the government address these issues as a matter of urgency.
A spokesperson for the charity Help the Aged welcomed the report: "For too long older people have been left confused and uncertain about their entitlement ?the current continuing care system is a confusing and distressing postcode lottery. Help the Aged hopes that whatever government is elected on 5 May will implement these recommendations as a matter of urgency and put an end to the confusion."(Madeleine Brettingham)